A new life to a three years old girl child

Wed, Mar 6, 2013 at 11:59 AM 
Miracle by Dr William Bhatti's team at the CMC
Ludhiana, 6th March, 2013:(Shalu Arora and Rector Kathuria): A 3 year old girl child, daughter of a labourer was suffering, with continuous pain in the lower abdomen and urinary infection for past threemonths. She was referred to the Department of Paediatric Surgery CMC and Hospital Ludhiana for further management. Investigations revealed that there was a 2.5 cms. long and 1.5 cms. thick,stone which was completely  obstructing the flow of urine from left kidney to urinary bladder and causing urinary infection and abdominal pain. Since there was no free flow of urine from kidney, there wasswelling and deterioration of kidney function with continuous abdominal pain.

Dr William Bhatti Professor and Head, Department of Paediatric Surgery and his teamdoctors, Dr N Bedi, Dr A Gupta and Dr S Dhuria, successfully performed laparoscopic removal of stone from the ureter. Theparents are happy as their daughter does not have a big operative scar on her abdomen and she is pain free because of the laparoscopic surgery. This type of operation, where the impacted stone at lower ureterovesical junction in a 3 year old child,was removed by laparoscopic operationis the first to be performed in India. So far this type of surgery has been done by open procedures which results in long scar marks and prolongedhospital stay. In laparoscopic surgery,the child will have 2-3 tiny scars of 5mm on their abdomen, with  less pain and shorter hospital stay as compared to open surgeries.

Dr William Bhatti further mentioned that presence of stones in urinary system is a common problem in children and it can be managed safely with laparoscopic operations. Parents should not ignore if their child complains of continuous abdominal pain and paediatric surgeons should be consulted immediately to prevent further complications.

The 8th National Stroke Conference Concluded

Delegates also attended from the SAARC countries 

                                                                                                                               Photos by Rector Kathuria

Ludhiana, 3rd March, 2013: (Shalu Arora and Rector Kathuria) The 8th National Conference of Indian Stroke Association organised by the department of Neurology, Christian Medical College, Ludhiana concluded today. There were 300 delegates who attended the conference from all over India including 18 International faculty members. Delegates also attended from the SAARC countries like Bangladesh. Yesterday there was a banquet for the delegates at the The Grand Pearl Resort. Mr RandhirKanwal the famous Ghazal singer entertained the guests. The medical students also displayed their artistic talent with a Bhangra dance.

Dr Jeyaraj D Pandian, Professor and Head of Neurology at CMC Ludhiana, the organising Secretary mentioned that all the major advances in stroke diagnosis and treatments were discussed in the conference. On the last day a special session on research in stroke was held and delegates from across the world discussed about the on-going important stroke trials and projects. A Skills workshop on the use of Botulinum toxin injection in treating stiffness of arms and legs following stroke was also held on the last day.
Dr Pandian said that for the first time a separate stroke rehabilitation skills workshop was held as a parallel meeting in CMC auditorium as part of the National stroke conference. More than 150 delegates attended this workshop which was organised by Dr Santosh Mathangi. One of the main highlights of the conference was the Teaching course on stroke which was held on Day 1 for MBBS students as a separate event at CMC. Medical students from three colleges in Punjab participated in this course.Dr Pandian stated that overall the conference had a major impact on the local doctors, neurologists, neurosurgeons, undergraduate medical students, physiotherapists, occupational therapists, speech therapists and allied health trainees from across the country. This would improve the care and treatment of stroke patients.

8th National Stroke Conference

Stroke is the second commonest cause of death

Inaugurated by Health and Family Welfare Minister of Punjab Madan Mohan Mittal

Formal inauguration by Shama Raushan by Health Minister M M Mittal      (Photo: Rector Kathuria)

Dr A.G. Thomas (Photo: Rector Kathuria)

Ludhiana, 1st March, 2013(Shalu Arora and Rector Kathuria):The department of Neurology at Christian Medical College, Ludhiana is organising the 8th National Stroke Conference of Indian Stroke Association from March 1st to 3rd in Hotel Park Plaza. The honourable Health and Family Welfare Minister of Government of Punjab Shri.Madan Mohan Mittal was the Chief Guest for the Inauguration of the conference. In his inaugural address the Health Minister stated that stroke is the second commonest cause of death and fourth leading cause of disability worldwide.In India 1.44 to 1.64 million cases of new acute strokes occur every year and 12% of strokes occur in the population aged below 40 years.  In India 40-50% of stroke patients are left with permanent disability. From the on-going Indian Council of Medical Research funded stroke survey conducted by CMC, in Ludhiana city the incidence rate i.e. number of new cases every year is 162 per 1,00,000 population. There is an enormous need to improve the stroke care in our country and in Punjab. ShriMadan Mohan Mittal also released the Stroke Solidarity String which is an Indigo colored string as a symbol of stroke support and awareness across the world.

Dr Abraham G Thomas, Director of CMC Ludhiana appreciated the efforts of the department of Neurology in bringing the conference to the city of Ludhiana. He also mentioned that Ludhiana city and Punjab has a very high number of stroke patients. CMC has a comprehensive stroke program to cater to the needs of the patients.
Dr Jeyaraj D Pandian the Organizing Secretary mentioned that today experts from India and overseas talked about how to diagnose and treat stroke patients as quick as possible in the ABC of stroke session. In the noon stroke experts discussed about acute stroke treatment with emphasis on thrombolysis.

Dr MR Sivakumar, President of Indian Stroke Association (ISA) mentioned about the various activities of ISA in improving the stroke care and awareness in the country. Dr Natan Bornstein (Vice-President, World Stroke Organisation), Dr Richard Lindley (President, Stroke Society of Australasia) and Dr Craig Anderson (President Elect, Asia Pacific Stroke Organisation) stated the importance of improving care of stroke patients in low and middle income countries like India. 

Dr Manoj K Sobti, member Punjab Medical Council and President, Indian Medical Association, Punjab explained the role of Punjab Medical Council in improving continuing medical education the State. Dr Yashpal Singh gave the vote of thanks. 
The conference will continue till Sunday March 3rd.

World Stroke Campaign

Annual convocation of CMC

The Gift of life 21 years later

Therapist uses art to help troops heal

Another achievement for CMC Stroke Unit

Awarded Indo-USA Brain Collaborative grant 

Ludhiana, 8th August, 2012. (Shalu Arora and Rector Kathuria)The Stroke Unit of Christian Medical College, Ludhiana has received a 1.18crores grant from the department of Biotechnology, India and National Institute of Health, USA. Dr. Jeyaraj Durai Pandian, Professor and Head of Neurology is the receipient of this award. This grant money is to develop a National Stroke Registry between India and USA. Dr. Pandian is the Principal Investigator from India and Dr. Aneesh Singhal, Stroke program, Massachusetts General hospital, Boston (Harvard University) is the Principal Investigator from USA in this grant. Dr. Pandian said that this research grant will help India and USA to develop a common stroke database and do cross cultural studies. New information regarding various risk factors for stroke, clinical services for stroke and reasons for delay in treatment are some of the important parameters that will be studied in this research. The information on stroke will be collected from 4 other centers in the country besides CMC Ludhiana. They are PGIMER Chandigarh, AIIMS New Delhi, NIMS Hyderabad and SCTIMST Trivandrum.
Dr. Pandian stated that this research proposal was selected out of 72 grant applications. Dr. Yashpal Singh, Professor of Neurology said that this Indo-USA collaborative registry will collect data for the next 2 years and many sub-studies will be carried out once the stroke registry is established. Dr. Abraham G Thomas, Director, CMC lauded the efforts of the Neurology department in getting the grant.    

CMC organized another event for patien

A Free Medical & Dental Health Check-up Camp
Ludhiana, 8th July, 2012: (Shalu Arora and Rector Kathuria) 

A  Comprehensive Free Medical Health Check-up Camp was organized at Sirish Hospital/CMC City Center,(B-XX 1140, Krishna Nagar, Ghumar Mandi), Ludhiana on Sunday, 08th July.  

Specialist Doctors from Christian Medical College and Hospital examined medical and surgical patients; for Skin, Pediatrics (Child Specialist), Ob/Gyn (Problems of ladies), Ophthalmologist (Eye Specialist), Dentist (Problems of Teeth), Ear, Nose and Throat, Orthopedics (Bones and Joints),etc.
The team of doctors, nurses and paramedical staff examined about 300 patients in the camp. This is the first time CMC Hospital has organized a free camp at Sirish Hospital.
Mr Gurprit Bassi (Gogi), Municipal Councilor, Chief Guest for the occasion, inaugurated the camp by cutting the ribbon. He lauded the efforts of CMC and Sirish Hospital for extending free medical check-up service to the community. He wished success for the camp and opined that such medical camps should be held more frequently. The camp was dedicated with a prayer by Rev Rogers.

Dr Sirish Chandra and Dr Baljinder Kaur expressed their gratitude to CMC Doctors for conducting this camp and for providing expert consultation for the patients.

Dr.A.G.Thomas, Director CMC, mentioned this camp is part of the commitment of CMC to serve the community by providing expert health care.

Also present on the occasion were: Dr Kim Mammen, Dr S C Khosla, Dr Vijay Obed, Mr Ashley Isaih. 

Early intervention for optimal treatment of squint

Every case of squint can lead to loss of stereo vision
Ludhiana, 2nd May, 2011(Shalu Arora and Rector Kathuria) Generally squint is considered important only from the cosmetic point of view. It is true that deviated eyes do not look good on a person’s face. Added to this is the psychological and emotional distress. However this is not the only deficit caused by squint, says Dr Satish Thomas, pediatric ophthalmologist and squint specialist at Christian Medical College & Hospital, Ludhiana. It can cause decreased vision because of amblyopia if the squint is in one eye. In addition, every case of squint can lead to loss of stereo vision or 3 dimensional vision.  We can have 3D vision only when both the eyes function simultaneously. Children with squint suppress image from one eye in order to avoid double vision, but in the process lose 3D vision.

Squint is best corrected as early as possible after its onset. This is because 3D vision can only be restored if eyes are realigned within about a year of onset, which is before 2 years of age. Amblyopia or lazy eye can only be treated before 7 or 8 years of age. If squint is to be operated only for cosmetic purposes, then timing of surgery does not matter as much. A surgeon can operate and correct squint at any age, but unless it is done very early in life, the patient cannot obtain any binocular vision and 3D perception ability. This is a very important criterion for many professions and careers like sports, surgery, becoming a pilot etc. It is extremely important even for most simple activities like threading a needle. Unfortunately many patients who come to us late have been advised by many doctors that they have to wait until they get older to have squint operated. Most squints do not improve with time and if we wait in the hope of spontaneous improvement, everything will be lost except a chance of straight eyes.
Dr Satish Thomas says that for the last 7 years, ever since he returned from doing fellowship in pediatric ophthalmology and squint from Sankara Nethralaya in Chennai, he has been earnestly campaigning for early treatment of squint. It is encouraging that over the last few years more and more patients are coming in earlier for treatment. In the last year Dr. Thomas said that he has seen close to 100 new children with squint in the hospital who have been appropriately treated. Twenty of them have been operated upon and many of them have been corrected with appropriate spectacles and occlusion therapy. However, the number of adults coming in with congenital squints is also on the rise. During the last year about 50 adult patients underwent surgery for squint which they had from childhood. This is a reflection of the society’s understanding of the disease which needs to change. Almost all the varieties of primary squint originate in childhood and need to be operated early in life for maximum benefits. 

A 30 years old Punjabi farmer got a new life from CMC

Bypass on a beating heart the risk of the repair is reduced:Dr.Bedi

A happy Mr Baljinder and family with Dr Harinder Singh Bedi 

Ludhiana, 17th March, 2012 (Shalu Arora and Rector Kathuria) Mr Baljinder Singh – a 30 year old farmer of Nakodar – was in a difficult situation. This young man had suffered 2 massive heart attacks 4 and 2 years back due to which his heart pumping was very weak and he was unable to breathe. He was investigated at heart hospitals in Chandigarh where it was diagnosed that besides blockage of his heart arteries he also had a severe leakage of his main heart valve (the mitral valve). He was in imminent danger of another heart attack but because of his double pathology (blockage + valve leakage) he was refused surgery. He then came to Dr Harinder Singh Bedi – Head of Cardio Vascular & Thoracic Surgery at the Christian Medical College & Hospital in Ludhiana. Dr Bedi realized that the valve leakage was not due to an intrinsic defect or tear of the valve but was due to the heart size becoming big (dilating) leading to failure of the valve to close properly. Contrary to popular Punjabi belief – Dr Bedi said – a ‘large’ heart is not really a healthy heart. The leakage led to a vicious cycle wherein the leak caused a further enlargement which in turn leads to more leakage. Till now the treatment was a complicated valve repair which was not always successful or a valve replacement which had its own problems.  A new repair technique is now being used all over the world – it is called a mitral valve repair using a McCartney-Carpentier-Adams Edwards IMR ring. This has been designed by Edwards company of USA in collaboration with world leaders in valve repair techniques – Dr McCartney and Dr  Adams from USA and the legendary Dr Carpentier from Paris . This technique was taught to Dr Bedi by the inventor Dr McCartney himself. Dr Bedi added his own modification by doing the bypass first on a beating heart - Dr Bedi is credited with having done the world’s first series of beating heart surgery and has a Limca World Record for the same. Dr Bedi explained that by doing the bypass on a beating heart the risk of the repair is reduced. The heart was then put on an imported heart lung machine for a very short time and stopped with ice. The heart chambers were opened and the valve repaired successfully with this new ring. The operation was successful and the valve leakage immediately stopped.

Baljinder is now doing well. The other members of the Heart team are Dr A Joseph, Dr S Garg, Dr Melchi, Dr Paul, Dr Deepak, Dr Vaishu, Dr Amruta, Dr Sarah, and Mr Jairus, and Mr William. Dr Bedi explained that if the valve had been changed Baljinder would have required life long close supervision and expensive medications. Dr McCartney has congratulated Dr Bedi and CMC on the excellent result and complimented him on his skills.

Dr Abraham G Thomas – Director of CMC & H – said that the CMC was committed to bringing International level expertise and equipment to the people of the region.

Population based stroke registry survey

Objective of the study is to find the burden of stroke
Ludhiana, 14th March, 2012 (Shalu Arora and Rector Kathuria)

Photo courtesy: Lourdes

The department of neurology at Christian Medical College is conducting a “Population based stroke registry survey” sponsored by the Indian Council of Medical Research (ICMR). This is a unique project being conducted in the country only in the city of Ludhiana under the HOD, Depttof Neurology, CMC&H. The burst of development, evolving socioeconomic status and wealth in the city has led to change in lifestyle, increased stress affecting the health of residents. The risk factors like hypertension, diabetes, heart diseases, alcohol consumption etc lead to stroke in the form of brain attack, paralysis, brain hemorrhage. In this national program, information about all the first stroke patients that occur in Ludhiana city, is being collected from August 16th 2010 onwards.

The objective of the study is to find the burden of stroke, stroke types and risk factors for stroke in Ludhiana city. The data collection is done from city birth and death division, selected health care institutions and scan centers.

The Deptt of neurology, CMC offers free check-up and blood test to stroke patients whose information could not be collected because, due to some reason, they received treatment outside of Ludhiana. The stroke should have occurred after August 16th 2010 and should be a first stroke with patient being above 18years of age. To seek appointment regarding the same you can contact Dr.Jeyaraj D.Pandian at 9915784750; Dr.Shweta Jain:9855334242; Ms.Gagandeep mehmi:7837743961; Mr.Amber sharma:7696575767. 

Therapist Uses Art to Help Troops Heal

The center provides treatment, recovery, rehabilitation and...
By Terri Moon Cronk
American Forces Press Service

Creative arts therapist Melissa Walker offers a wealth of supplies to service members to complete their art projects in the Healing Arts Program at the National Intrepid Center of Excellence at Walter Reed National Military Medical Center in Bethesda, Md. Walker developed her program to help those with psychological health issues and traumatic brain injuries. DOD photo by Terri Moon Cronk 

BETHESDA, Md., March 8, 2012 - An art therapist is using the power of creativity to help service members heal from traumatic brain injuries and psychological health issues, including post-traumatic stress disorder.

Melissa Walker designed the Healing Arts Program at the National Intrepid Center of Excellence on the campus of the Walter Reed National Military Medical Center here. She is the program's sole art therapist, and also serves as its coordinator. The program aims to help the recovering service members find a creative haven where their buried post-war thoughts and emotions can come to the surface through art and therapy.
With gentle encouragement from Walker, active-duty troops create their way to healing. By working on their art projects in a personal manner, they confront the circumstances of their injuries and begin to overcome the uncertainty they might feel, she said.

"What's bothering them runs the gamut of that moment in time: ... the frozen trauma, the frozen memory. They can't seem to shake what they've internalized," Walker said.

Service members with psychological health issues and traumatic brain injuries create an endless variety of designs on papier-mache masks to help them clarify their thoughts and sense of self, art therapist Melissa Walker said. Their designs vary from their war experiences to picturing themselves as healing while undergoing treatment at the National Intrepid Center of Excellence at Walter Reed National Military Medical Center in Bethesda, Md. DOD photo by Terri Moon Cronk.Download screen-resolution                                    Download high-resolution

The center provides treatment, recovery, rehabilitation and, sometimes, reintegration to active duty for service members who have psychological health issues and traumatic brain injury. All have mild to moderate post-traumatic stress disorder, and most also have had some kind of head injury from exposure to a blast injury or fall, Walker said.

When these service members come to the center, they're often in a confused place, and some experience a loss of identity. Those who want to return to duty have a difficult time because they're passionate about their jobs, and those who will rejoin the civilian world wonder what they'll face, she said.

"They need to realize, 'It's time to take care of myself,'" she said.

Art therapy is one element of the center's interdisciplinary treatment. Walker, who designed the Healing Arts Program when the center opened two years ago, said creating art slows down the brain so people can focus and improve their cognitive skills and hand-eye coordination.

Walker's interest in the effects of war on troops stems from childhood memories of her grandfather returning from military service in Korea with what she now believes was post-traumatic stress. But, she said, "there wasn't a name for it then." White House, Defense Department and Veterans Affairs officials have made traumatic brain injury and post-traumatic stress treatment and prevention a top priority during the past decade of war.

By their third week in the Healing Arts Program, Melissa Walker assigns service members montages to design that signify their experiences at the center and characteristics they see in themselves. One wrote a poem in a creative writing class and incorporated it into his montage, which Walker said brought him "full circle." The art therapy program is a four-week piece of the treatment plan at the National Intrepid Center of Excellence at Walter Reed National Military Medical Center in Bethesda, Md., for those with psychological health issues and traumatic brain injuries from their service in Iraq and Afghanistan. DOD photo by Terri Moon Cronk.
Download screen-resolution                                          Download high-resolution
  

Walker begins her treatment by meeting the service members one-on-one so she can get to know them and their goals while they are at the center. This also helps her meet the art therapy needs of each small group of about five people, she said. She has the service members design a mask, a montage and a postcard in any design with any materials they want, from magazine clippings to beads and paint. Most of their artistic creations, she said, reflect their inner thoughts concerning deployment, their injuries, various war experiences, and their futures.

Since the start of the wars in Iraq and Afghanistan, military officials have recognized family members' needs for support, and Walker's Healing Arts Program is no exception. One night a week, family members come to Walker's family class to do the same projects as the service members, to give this group of caregivers a break and a chance to "breathe," Walker said.

Service members' mask designs vary, she said, recalling a service member who divided his mask into the halves of two faces, depicting how he saw himself as both a civilian and a member of the military. The split-self has to do with identity, she said. Some who still have war images in their minds might design a scene of the injuries they and their fellow troops suffered.

The groups discuss their mask creations and what they mean. Walker said these discussions bring up personal and symbolic experiences. Sharing and discussing artwork establishes a sense of community and bonding with one another, which is particularly helpful to those with post-traumatic stress who tend to isolate themselves and don't trust others, she said.

"Some feel a lot has been lifted off their shoulders," she said of the group discussions. "Some will share things they never have before and feel validated. They realize they aren't alone."

Walker said the service members with psychological health issues and traumatic brain injury have "layers and layers of complications." In a similar manner, the montages they design often reflect the past, present and future of who they are, which helps them clarify their sense of self, Walker said.

The art therapist described the montage of another student who created a representation of himself in three stages: gradually coming from the dark side of war, opening a door labeled "NICoE," and stepping into brightness to depict healing, she said.

Walker's goal at the final week's commencement is to leave each
service member in "a forward-thinking mode," by asking them to design a postcard with a "positive" hand-scribed note for one of the center's recent graduates.

"One wrote, 'Remember what you learned here,'" she said.

Walker said she is confident future studies will bear positive results of art therapy for those with PTSD and TBI. For now, she added, she stands determined to help people confront and cope with their wounds by expression through art.

"I always tell them, 'I'm so glad you're here and taking time for yourself, and the biggest step you've taken is being open to this,'" she said. "That's huge. That's brave."

Related Sites: National Intrepid Center of Excellence Walter Reed National Military Medical Center

Be aware ….Save The Kidney

Kidney diseases are often detected too late

Photo Courtesy: Health Medical 

Awareness of Kidney Diseases is low with many people totally underestimating the vital role our kidneys play, when in fact kidney damage and disease causes serious morbidity for hundreds of thousands of people, and in some cases leads to death. Chronic diseases – that already account for 72% of the total global burden of disease in people over 30 – will increase by 17% over the next decade; much of this in developing countries like India.

Our kidneys remove toxins and excess water from our blood. They also help to control our blood pressure, to produce red blood cells and hormones, and to keep our bones healthy.

There is a close relationship between kidney diseases, diabetes and hypertension. Worldwide, 246 million people suffer from diabetes and the figure is expected to reach 380 million by 2025. Diabetic kidney disease affects a third of people suffering from diabetes.India has about 50 million diabetic patients and diabetes affects the kidneys in 30-40% patients with renal failure related to diabetes accounting for about 20% of patients on dialysis.  Unfortunately, less than half of those people diagnosed with diabetes undergo a simple screening test for kidney disease.

Kidney diseases are often detected too late, when the patient is already in end-stage renal failure and will need either dialysis or transplantation. Worldwide, over 1.5 million people are undergo dialysis or transplantation and this number is forecasted to double within the next 10 years. In India only a small percentage of people can afford dialysis and transplantation.

A simple way to prevent these issues is to tackle the problem at the source, and ensure early diagnosis of kidney damage by systematically screening people diagnosed with diabetes or hypertension. This can be done with simple and inexpensive urine tests. If detected early, damage can be treated with effective therapies. If diagnosed too late, kidney diseases lead to kidney failure, which entails dialysis and transplantation. 

World Kidney Day

Celebrated worldwide onthe second Thursday of March, World Kidney Day offers a crucial, visible opportunity to inform and educate health policy-makers, people who are at highest risk of CKD, and the general public that kidney disease is common, harmful and treatable.

The Department of Nephrology at Christian Medical College, Ludhiana, will be organizing a Kidney Health Camp in the nephrology OPD from 8 - 11 AM on 10^th March, 2012, which will include free registration, nephrology and diet consultation, screening urine and blood tests, health education and awareness promotion.Please feel free to check your kidneys especially if you are diabetic, have high blood pressure, smoke, use regular pain medications, are above 40 years of age or have a close relative with diabetes or kidney disease.

For Further Details Please Contact  Dr.Jasmine Das: 9988345898
by Shalu Arora and Rector Kathuria

An appeal for Anil

7 year old was born with only one pumping chambers

Anil with his mother and Dr HS Bedi in CMC

Young Master Anil  s/o Dev Nandan and Pano Devi  is in a difficult position. This 7 year old was born with one of his 2 pumping chambers of the heart absent. Due to this his growth has stopped and he is constantly blue. He was seen by numerous doctors all over India. He then consulted Dr Harinder Singh Bedi – Head of the Department of Cardio Vascular & Thoracic Surgery at the prestigious Christian Medical College and Hospital in Ludhiana. Dr Bedi realized that the defect if uncorrected could be fatal as the body could not tolerate low oxygen for a long time.

He explained that the heart has 2 pumps – the left and the right ventricle. In Anil – there is just one. Consequently all the blood (good and bad) mixes in this pump and gets circulated. As this is a mixed blood it is impure or blue and the whole body including the brain is always short of oxygen.
Dr Bedi has trained at one of the most advanced paediatric heart surgery centres in the world – the Royal Alexandra Hospital for Children in Sydney. Even there – Dr Bedi says- children with such advanced stage are not seen as the get operated much earlier. Anil will need a major open heart surgery where the surgeons will try and make a new heart for Anil using an imported heart lung machine. Anil’s father is a labourer and cannot afford the treatment even after a major concession by the hospital. Any donations may be made in the name of:    ’Christian Medical College   , Ludhiana’    with Anil’s name at the back. All donations are tax exempted.
Anil wants to get better so that he can study. Dr Bedi said that after surgery Anil should be able to handle any profession of his choice.

Dentist Plays Vital Role in Afghanistan

By Air Force Airman 1st Class Tom Brading American Forces Press Service JOINT BASE CHARLESTON, S.C., Jan. 12, 2012 - In a remote valley of war-torn Afghanistan, an airman home- based here is playing a vital role enhancing the country's practice of dentistry. Air Force Maj. (Dr.) Courtney Schapira poses with, from left, dental technician Nasir, dental clinic chief Dost Muhammad and dentist Janat at Forward Operating Base Lightning, Afghanistan, Dec. 1, 2011. U.S. Air Force photo by Staff Sgt. Sarah Martinez  Air Force Maj. (Dr.) Courtney Schapira is deployed to the medical embedded training team at Forward Operating Base Lightning as the chief dental advisor at Paktia Regional Military Hospital in Gardez, Afghanistan."Our team is made up of 21 medical advisers from different NATO countries," Schapira said. "We each have our own areas of expertise, such as internal medicine, nursing, pharmacy, etc." Schapira deployed to Afghanistan in November and is the first and only dental adviser assigned there. "The Afghan dentists that I work with are excited to have a U.S. dental advisor and are eager to learn from me," she said. "They are asking questions and taking the initiative to do things on their own." Paktia Regional Military Hospital is an Afghan army facility that treats only Afghan soldiers, police and civilians with combat-related injuries. The standard of dental care in Afghanistan is much different from that in the United States, Schapira said, noting the clinic is not current with modern preventive dentistry. Though the Afghan dentists are skilled and adequate at their profession, Schapira said, their techniques and materials and the thought processes behind their treatments are outdated. "The dentists here used to rarely make patients numb prior to treatment," she said. "This is both painful for the patients and can turn what may be a single appointment in the U.S. into two or three appointments here, simply because the patients can only tolerate so much pain. Since my arrival, they now numb patients prior to any surgical procedure." During her first few weeks in Afghanistan, Schapira said, she felt overwhelmed by the challenges facing her. Her efforts were divided in multiple directions. Supplies, broken equipment, outdated techniques, infection control and patient administration all needed her attention. "I realized I couldn't improve everything at once," she said. "So I set goals for myself and for the clinic. After most of the equipment was modernized, I turned my focus to the supply inventory." The 6-by-10-foot supply closet was full of unlabeled boxes filled with assorted dental supplies, Schapira said. It was overflowing with supplies, she added, and it was difficult for anyone to even walk in. In addition, she said, she found the Afghans lacked a tracking system to monitor expiration dates or maintain inventories. "The disorganization made it very difficult to find any materials they actually have," she added. Most of the supplies on hand were donated by various hospitals before Schapira arrived, but because the Afghans never had a dental advisor in the past, she said, the staff never was taught how to stock and inventory the materials. Once she organizes the supplies, Schapira said, she'll be able to more accurately assess the clinic's real capabilities and needs. "Organization has been our top priority," she said. "It has created a foundation for the clinic to grow. Now that everything is in order, training will become our top priority." With most of the equipment now working properly and with the supply closet organized, Schapira said, she can start working more on infection control procedures, new dental techniques and patient administration. "I've set the Afghan dental clinic up for success," she said. "I'm getting the clinic to reach its fullest potential. I have complete confidence in their capabilities."

Related Sites: NATO International Security Assistance Force

Military's Groundbreaking Vaccine

Targets Breast Cancer

By Elaine Sanchez American Forces Press Service SAN ANTONIO, Jan. 6, 2012 - Military researchers here have developed a cutting-edge cancer vaccine that's slashing breast cancer recurrence rates and giving some survivors a better shot at a cancer-free future. Army Col. (Dr.) George E. Peoples explains how cancer vaccines help to combat breast cancer during an interview at San Antonio Military Medical Center. Peoples, director and principal investigator for the Cancer Vaccine Development Program, has helped to develop a vaccine that's offering breast cancer survivors hope for a cancer-free future. DOD photo by Linda Hosek  After more than a decade of research and testing, the cancer vaccine, dubbed E-75, soon will move on to its final phase of testing to earn Food and Drug Administration approval, said Army Col. (Dr.) George E. Peoples, director and principal investigator for the Cancer Vaccine Development Program at San Antonio Military Medical Center here.The team has high hopes for this vaccine and its lifesaving potential for breast cancer survivors, particularly since breast cancer is the most prevalent type of cancer seen among military beneficiaries in the hospital here, said Peoples, who also serves here as the deputy director of the U.S. Military Cancer Institute and the medical center's chief of surgical oncology. "We've made a commitment to take care of active-duty personnel, spouses and retirees," the colonel said. "And cancer is a notable problem among beneficiaries." The vaccine, Peoples explained, targets a protein commonly over-expressed in breast cancer cells called human epidermal growth factor receptor 2, or HER2/neu. Cancer vaccines typically target some protein or antigen expressed on cancer cells, he noted. "The idea is to train the immune system to recognize that protein or piece of protein that's highly expressed on cancer cells, but not on normal cells," he said. "That way the immune system can differentiate what's abnormal and normal. If the immune system can recognize it, it marks it for death, basically." The cancer vaccine concept has been around for a long time, Peoples noted, but the team here has adopted a different approach to test their effectiveness. The vast majority of vaccines in the past were tested on end-stage cancer patients, he explained. However, a vaccine is meant to stimulate the immune system, and a healthy immune system isn't typically seen in someone in the last stages of cancer. As a result, "a lot of early cancer vaccines tested ... in end-stage patients were found not to be helpful," Peoples said. "No real surprise there." To more appropriately gauge the vaccine's effectiveness, Peoples' team decided to test it among patients who have a healthy immune system -- cancer survivors who are disease-free but at risk for recurrence. Experts can predict recurrence based on several factors including family history, age, size of tumor and the presence of involved lymph nodes, among other indicators. The researchers targeted the HER2/neu protein, which is expressed at varying levels in women with breast cancer, then honed in on the 60 percent of women who express the protein at low to intermediate levels. The vaccine is a mix of the E-75 peptide of the HER2 protein and an immune system stimulant. They started with a 200-patient trial in 2001 and followed each woman for five years. Half of the women received the vaccine -- one injection a month for six months -- and the other half was the control group. The outcome was very promising, Peoples noted. The recurrence rate among the women in the control group was 20 percent, and 10 percent among the women who received the vaccine. "We cut recurrence in half," he said. This success led to the next phase of testing, the colonel said, which will begin early this year and involve 700 to 1,000 patients. Unlike the earlier phases, however, this step will be undertaken by a commercial company, Galena Biopharma, which has the resources and manpower to undertake such a large-scale test. The company will seek FDA approval and, if received, release the vaccine for public use. This phase will take about five years to complete -- two years to enroll, then a three-year observation period, Peoples said. "The end point is the recurrence rate after three years," he explained. Meanwhile, Peoples and his team will turn their attention to a multitude of other projects, many based on the same concept that made the E-75 vaccine so successful -- using the body's own immune system to destroy cancer cells. They've already taken the same vaccine and completed a trial with prostate cancer survivors. As with ovarian and lung cancer, prostate cancer also expresses the HER2 protein. Peoples said he's also intrigued by a successful trial they conducted on breast cancer survivors who express the HER2 protein at the highest levels, rather than the low to intermediate levels they focused on before. In this study, they combined their vaccine with the drug Herceptin. They conducted a small trial with 60 women, Peoples said, and when they administered the vaccine and Herceptin together, the recurrence rate dropped to zero. "The preliminary data is very exciting," he said. "But we need to wait and do larger trials." Word has spread of the cancer vaccine program's successes and intriguing results. Military and civilian experts have approached Peoples wanting to take part in research that has such a potentially widespread impact. The idea of active, specific immunotherapy -- engaging the body's immune system to do the work of fighting the cancer -- is an exciting and rapidly evolving area, Peoples explained. Garnering this interest, Peoples has steadily built a worldwide network of military and civilian hospitals that can assist with clinical trials and research. The network includes just about every major military hospital alongside a civilian hospital in cities across the nation and overseas. The partnership has reached Athens, Greece, and is about to extend into Malaysia. "We're about to circle the globe," he said. Peoples attributed much of the program's successes to this military-civilian network. "We're very fortunate to have great partners," he said. He also praised the military men and women willing to take part in the trials. They enter into them knowing they may be part of the control group that doesn't receive a potentially lifesaving vaccine. Despite that fact, he hasn't seen a shortage of willing participants, Peoples said. "The military is an ideal setting for clinical trials," he said. Service members, retirees and family members have a strong sense of service, he noted. "They want to be involved and contribute to the research," he added. While they're focusing on secondary cancer prevention, the ultimate goal, Peoples noted, is primary prevention, meaning cancer prevention among people with a predicted risk of cancer based on family history and genetic markers. "Hopefully, sometime in my lifetime we'll figure that out," he said.

Related Sites: San Antonio Military Medical Center

Florida Woman Loses 84 Pounds to Join Army

By Cynthia Rivers-Womack
U.S. Army Recruiting Command

GAINESVILLE, Fla.,Jan.3, 2012:Allison Scarbrough officially changes jobs today, from retail cashier to health care specialist in the U.S. Army. But the change has not been easy.

Allison Scarbrough of Gainesville, Fla., lost 84 pounds to qualify for service in the Army. U.S. Army photo

Scarbrough, then 20, walked into the recruiting station here in May 2010 ready to become a soldier. But because she carried 240 pounds on her 5-foot, 5-inch frame, she had to lose 84 pounds and keep the weight off before she would be eligible to enlist.In 2010, Scarbrough belonged to the country's growing demographic of 18-to-24-year-olds considered overweight and obese. In 1998 -- when the National Institutes of Health released the first federal guidelines to identify, evaluate and treat overweight and obese adults -- 97 million Americans, or 55 percent, were identified as overweight or obese.
A Centers for Disease Control and Prevention study revealed that in 1998, only one state had 40 to 49 percent of its 18-to-24-year-old population classified as overweight or obese. By 2008, that number had grown to 39 states. The CDC uses a height-weight calculation known as body-mass index, or BMI, to determine whether someone is overweight or obese. The Army also uses BMI measurements to determine weight, with different calculations for men and women.
Keenly aware of weight-management issues among its active-duty and reserve soldiers, Army officials began offering the service's "Weigh to Stay" program online in 2006. The initial program was designed for in-person sessions, but the online platform made the program more accessible and self-directed, according to a 2006 interview with Army Lt. Col. Danny Jaghab, site creator and past nutrition staff officer at the U.S. Center for Health Promotion and Preventive Medicine at Aberdeen Proving Ground, Md. In addition, the Army now provides a platform at http://www.hooah4health to help soldiers in their goals to maintain a healthy lifestyle.
When Scarborough realized she could not join the Army until she lost 84 pounds and kept it off, she said, she changed her behavior toward food and modified her lifestyle and eating habits. She began eating more vegetables and doing away with high-caloric drinks, fast-foods and unnecessary snacks.
Encouraged by her recruiter, Army Staff Sgt. Terrance Retsch, Scarborough started physical training in September 2011 with the future soldiers of the Gainesville recruiting station.
"I knew when Scarbrough came into our office she would take the challenge to lose weight and would be successful," Retsch said. "She's determined and strong-willed, plus the Army gave her a bigger purpose that had immediate and long-term benefits: improving her health and becoming a soldier."
Scarbrough said the transition has been good for her body and her mind.
"Weight shouldn't be something that stops you from doing what you really want," she said. "Losing weight is a lot of work, but even when you hit a plateau you have to keep at it. My mother didn't think I would follow through with losing the weight or joining the Army, but I did it, and now I'm ready to go."

DOD to Honor Blood Donors for Saving Lives

People can donate whole blood every 56 days
we split that unit into plasma and red cells
National Blood Donor Month

By Army Sgt. 1st Class Tyrone C. Marshall Jr.
American Forces Press Service

WASHINGTON, Dec. 12, 2011 - The Defense Department plans to recognize blood donors early next year for their critical contributions to saving lives by giving blood to the Armed Forces Blood Program, the program's director said today.

"National Blood Donor Month, which is usually January of every year, is an attempt to recognize those blood donors and everyone involved in blood donation for their sacrifices and rolling up their sleeves in 2011," Army Col. Frank Rentas, director of the Armed Forces Blood Program, said during a Pentagon Channel and American Forces Press Service interview here.

"Next month ... we will be recognizing those donors that have supported our mission," he said. "Our mission is to provide blood and blood supplies whenever and wherever they're needed."
The joint program plays a key role in providing quality blood products for service members and their families in both peacetime and war, according to its website.

Rentas noted the demand for blood -- which only lasts 42 days in storage before perishing -- and shared different needs for blood donation which are based on the needs of the war fighter.

"Most people, when you say 'blood,' they refer to red blood cells," he said. "With red blood cells, O-negative is the most sought-after blood type because you can transfuse it to anyone out there.

"If you are looking at plasma, it's completely opposite," Rentas continued. "AB plasma is what we need because AB plasma is universal. So depending on our needs, we may target specific donors or specific blood types depending on what we need for a specific week."

The program director detailed the importance of receiving donations since one donor can potentially save three lives.
"If they're donating whole blood ... we split that unit into plasma and red cells," he explained. "One donation can actually save three different lives because we can make platelets out of some of those units as well.

"So the platelets can actually go to one recipient, the plasma can go to another, and the red cells can go to another," Rentas added. "So that would be three different recipients that you can save with one donation."

People can donate whole blood every 56 days, Rentas said, but some aren't eligible to donate. "Overseas, depending on where you are, you may or may not be able to donate," he explained.

An example, Rentas said, is people who were based in Europe in areas afflicted with what is known as Mad Cow Disease. "Even though I'm an O-negative blood donor, and donated many, many times in the [1980's], I was assigned to Germany from 1987 to 1990," Rentas continued, "and I have not been able to donate since because of Mad Cow Disease. Even though I feel perfectly fine, I'm not allowed to donate."

The colonel cited the Federal Drug Administration as the authority which dictates policies and guidelines to both civilian and DOD blood donor facilities.

"We're licensed to collect because we do have an FDA license," he said. "So we need to follow their policies ... one of their policies is if you have been in specific places where Mad Cow Disease has been a concern, you're not allowed to donate."

People can donate blood at more than 20 sites worldwide. Those who cannot donate blood, can still contribute by passing on the word, Rentas said.

"The best place for [service members] to get information is our website, www.militaryblood.dod.mil," he said. "[It has] anything that they need to know about locations, they can make appointments [and] reasons about why they may not be able to donate."

Rentas expressed his gratitude to donors for "rolling up their sleeves" to give blood and he encouraged them to continue to support the program.

"If you come to a DOD blood donor facility in January, we're going to be holding recognition ceremonies to express our gratitude for what you have done in 2011," he said.

Related Sites:
Armed Forces Blood Program

Workshop in College of Nursing, CMC & Hospital

61 participants attended from Punjab and Srinagar

Ludhiana, 15th December, 2011(Shalu Arora) College of Nursing, Christian Medical College & Hospital, Ludhiana organized one day workshop for Nursing Superintendents from Punjab State on HIV/AIDS care.
College of Nursing is conducting Training for Staff Nurses for HIV/AIDS patient care since 2009 under the Global Fund for AIDS, Tuberculosis & Malaria (GFATM) Project.  So far conducted 47 workshops and trained 1410 staff nurses, Punjab and Jammu & Kashmir.

This workshop was organized for sensitizing the Nursing Superintendents regarding HIV/AIDS Nurses’ Training (GFATM).  Total 61 participants attended the workshop from various districts of Punjab and Srinagar.  Dr.  Subash Batta, Civil Surgeon, Ludhiana was the Chief Guest on the occasion briefed about the HIV/AIDS scenario in Punjab.

Other dignitaries present on the occasion were Dr. Abraham G. Thomas, Director, CMC & Hospital, Ludhiana; Dr. Uggar Singh Souch, Distt. Programme Officer, Ludhiana; Dr. Daljit Singh, S.M.O., Eye Mobile, Ludhiana; Dr. Kanwal Masih, Medical Superintendent, CMC & Hospital, Ludhiana; Dr. Kim J. Mammen, Associate Director, CMC & Hospital, Ludhiana.  Resource persons were from Indian Nursing Council and Futures Group, New Delhi. Programme ended with valedictory session.